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NPI Code Detail

MEDICARE: MRS. ADRIENNE CLAIRE JEFFRIES LCSW

MEDICARE: MRS. ADRIENNE CLAIRE JEFFRIES LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerC012067NC
2171M00000XCase Manager/Care Coordinator
31041C0700XClinical Social Worker25432MD

General Provider Information

NPI Number : 1871811505
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ADRIENNE CLAIRE JEFFRIES LCSW
Provider Business Mailing Address
First Line : 2925 QUEENSBERRY DR
Second Line :
City : HUNTINGTOWN
State : MD
Zip : 20639-2325
Country : US
Telephone Number : 774-413-0157
Fax Number :
Provider Business Practice Location Address
First Line : 1819 BAY RIDGE AVE STE 190
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21403-2834
Country : US
Telephone Number : 443-281-9430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2010
Last Update Date : 10/16/2019

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